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MEMBERSHIP APPLICATION |
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NAME |
AGE |
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STREET ADDRESS |
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CITY |
STATE |
ZIP |
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EMAIL |
PHONE # |
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NOSTALGIA GASSER INFO |
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(PLEASE ATTACH PHOTO OF CAR) |
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YEARLY
DUES: $25 US and $30 for Canadian residents
Dues
payable each October 1st. MEMBERS RECEIVE:
- CLUB
DECAL
- MEMBERSHIP
CARD
- MONTHLY
NEWSLETTER WITH PHOTOS
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Print out this form and send a check
for $25.00 (or $30.00) to:
EAST COAST GASSERS
210 DORCHESTER DRIVE
SELLERSVILLE, PA 18960 |